More than 3,000 nursing home beds in Massachusetts are offline due to staffing shortages. But facilities need to be able to pay a living wage to have a chance of countering major workforce crisis, the state’s leading sector advocacy group testified Monday.
Massachusetts Senior Care Association President Tara Gregorio testified before the state Joint Committee on Elder Affairs to propose modifications to two bills moving through the legislature. Both are designed to help nursing homes recover from the effects of the pandemic. The bills would create a certified nursing assistant training program; establish grants for supervisory training and career advancement; require MassHealth – the state’s Medicaid program – to recognize the need for facilities to pay a “living wage”; and require an analysis by the Health Policy Commission of SNF staffing requirements to meet residents’ needs.
Gregorio’s testimony, provided to McKnights Long-Term Care News on Tuesday, noted that 70% of residents are MassHealth beneficiaries, but the program underfunds the cost of care by at least $27 per day. The gap between what the state provides and what care costs is nearly $200 million, according to Gregorio’s prepared remarks.
“The state’s 356 nursing facilities provide a core state service to 33,000 frail elders and disabled individuals who can no longer be cared for safely at home,” Gregorio told lawmakers. “In order to meet the care needs of current residents, the vast majority of directly employed staff are working overtime. … And as a result of the workforce crisis[,] over half of the state’s nursing facilities are intermittently denying new admissions.”
In conjunction with the testimony, the association released a survey of occupancy rates showing the sector in Massachusetts is near capacity with its current bed restrictions. The statewide average operating occupancy is 93%, and every county is operating at more than 90% of occupancy.
There are 8,000 open vacant jobs at nursing homes — roughly one in every five jobs, according to the association. Facilities continue to rely on staffing agencies to supplement personnel, and Gregorio said SNFs spent nearly $300 million on agency staff last year.
“Not only does temporary nursing agency use decimate the employed staff morale, it also is disruptive to continuity of resident care, and the charges are exorbitant and unsustainable based on current Medicaid funding,” Gregorio said in her testimony.
Gregorio proposed amending the two bills that the Legislature is considering to include:
• Language consistent with the Nursing Facility Task Force Report that recognizes the complete costs of care and funding for “competitive living wages;”
• Creation of a Certified Medication Aide to allow individuals with this certification to dispense non-narcotic medications to residents, as is done in more than 30 other states;
• Greater accountability and transparency requirements for staffing agencies as well as mechanisms to control agency fees.
